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Avoiding Arthritis

In 1959, JOHN GILL laced his Zillertal Klettershue, planted his left foot and fired the Red Cross Overhang, which instantly became the most difficult rock climb in the world. The dynamic one-move eliminate, now graded V9, in the Tetons, Wyoming, still sees very few ascents done in the original style. Whereas Gill grabbed the blocky rose quartz and extended to a crystal nubbin, I launched from an obvious crimp that drops the grade two points.

It's just one move, I kept telling myself. I threw and failed, threw and failed. This one devious Tetons pebble crimp infatuated me for two weeks, ominously swelling the aching joints in my right hand. Yet moonstruck, like a rookie, I took no rests.

Eventually, my proximal interphalangeal joints (the biggest joints of the finger) were so swollen that my fingers lost mobility and morphed into claws. Any climbing workout resulted in severe finger pain that could last more than a week. When my insurance upgraded, I saw a doctor.

"You have arthritis," he said.

"What?"

"It looks like you've developed osteoarthritis, a degeneration of cartilage caused by overstressing articular weight-bearing joints. In this case, your fingers."

All I could think was, I'm only 24 years old. This is bogus!

A few months before, I'd read an article claiming conclusive evidence that there was no positive correlation between climbing and arthritis. Yet now I was staring arthritis in the face.

While the doc looked at my X-rays he explained what I already suspected: My synovitis, the first stage of arthritis in which joints inflame and begin degenerating cartilage, was a result of climbing.

But I heard that climbing and arthritis aren't related, I said to Elizabeth Logan, Occupational Therapist, Registered, Licensed (OTR/L) and Certified Hand Therapist (CHT), whose practice in Jackson Hole sees its share of debilitated climbers.

Some climbers are more prone than others, she said. Osteoarthritis is caused by putting stress on joints.

A number of factors predispose some climbers to arthritis of the hands. Causes for concern include going hard for many days in a row, constant crimping, climbing in the cold, family history of weak joints and previous trauma (like a fracture or ligament damage; tendon injuries have no correlation). Lucky me, I had all five.

While undergoing physical therapy, I continued to climb. Instead of crimping Red Cross, however, I climbed long moderates. At times, I received funny looks as I performed the exercises and practices I'm about to share. But, three months later, my fingers were straight, and I was back on the send train.

Whether or not your joints already have started down the arthritic path, they might someday. The following tips are designed to keep you climbing free of joint pain.

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#1 OPEN UP

You probably crimp in the closed position: fingertips on the hold's edge, first joint of each finger bent down, and its second joint bent up. This technique offers mechanical advantage but is a dangerous habit. The leverage created by closed crimping puts excessive stress on your fingers. Keep doing it for a decade or two, and the resultant swelling can transform your fingers into sausage links.

Always crimp in the open position, holding every small edge like you would a jug, hanging from it with your joints only slightly bent, so your fingers are in the shape of a crescent. This will build finger and forearm strength and protect your joints. At first, this method is frustrating because it relies on muscles you may not yet have developed. But practice develops burlier fingers than relying on the leverage that closed crimping provides.

Another bad habit is over gripping, which also unduly strains your joints, especially when you are pinching. To see for yourself, pinch something nearby and give it hell. You'll quickly feel the greatest pressure exerted where your bones meet at the proximal interphalangeal joint.

Over time, the abuses of closed crimping and over gripping can swell your synovium, the fluid-filled sac that protects your joints. Although your body means for the swelling to be protective, inflammation begins to break down the joint's protective cartilage.

To avoid this degeneration, start using common hand-strengthening products like putties, grip tools, handheld exercise balls and rubber bands. They're cheap and don't require a drive to the gym. Using these to pinch and hook with your fingers, statically squeeze/stretch hard for 10 seconds at a time, is a trauma-free way to strengthen the muscles in your hand and forearm, which have been underdeveloped by all those years of closed crimping.

Most athletes know that cross training keeps opposing muscles in balance and less susceptible to injury. Until my finger problem was diagnosed, I did not realize how important this process is for tendons as well.

Climbers pulling hard often over develop their flexor tendons (those used for gripping, on the palm side of your arm) and underdevelop their extensor tendons (those on the top side, or dorsum), a recipe that puts extreme stress on finger joints, your arm's weakest link. However, a combination of massage and stretching will empower your extensors to harmonize with your flexors.

At the crag, stretch your arms before and after your session (See Warm-Up, Page 48).

One of the most common climbing stretches, the prayer, is helpful for boosting your extensors. Touch your palms together, line up your fingers and point them upward. Then, raise your elbows. Push the fingers of each hand together until you feel a good stretch down your fingers, through your palm, and into your forearm. Hold this position for 10 seconds and repeat.

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#3 FIGHT SWELLING

Just as you'd wrap an ankle after spraining it, wrap swollen finger joints after climbing to coerce the accumulation of watery fluid in cells or tissues to evacuate the joint, leaving only beneficial synovial fluid.

Create finger socks with elastic medical tubing or wrapping (Coban wrapping is a good choice that's easy to find) for painless compression. Whether you are using specialty medical supplies or home remedies such as athletic tape, distribute slight pressure equally around the joint. Hindering circulation with a tighter bandage would defeat the purpose, as fresh, circulating blood brings nutrients to the healing area.

While you are climbing, tape any inflamed joints so that they are less mobile. This action helps protect your tendons by restricting muscle flexing as well as reminding you to avoid overstressing your joints. (If you feel your joint trying to explode from the constrictions of the tape, you are closed-crimping or squeezing too hard. Stop it!)

#4 IMPROVE YOUR DIET

Great joint foods are those high in monounsaturated fats and Omega-3 fatty acids. Foods particularly rich in both are olive oil, walnuts, avocado and organic peanut or almond butter. These healthy oils actually lubricate joints and curtail their inflammation.

Some climbers alleviate joint pain with supplemental glucosamine/chondroitin. Although effective in reducing pain, the pills are expensive, do not directly cause healing (they only reduce the pain and decrease swelling), and must be taken indefinitely for continuous benefits. Try the other methods listed above before buying these drugs. If you try the pills and notice no improvement in pain or swelling after six weeks, consider that a study cited in Prescriber's Letter (2006) indicates that the supplements will not generate a positive effect for you, no matter how long you take them. [For more on supplements, see page 44.]

#5 GO WITH THE FLOW

Encourage blood flow to an inflamed joint. Elizabeth Logan recommends a heat pad: It makes tissues extensible and joints more mobile. Massaging Arnica (a topical homeopathic gel or cream) into the inflammation also loosens the problem area and attracts blood.

I took my doctors' advice, which meant adhering exclusively to the above tips while still being allowed to climb. The result? Happier joints, less pain, more mobility, and no more worries about permanent damage. In those eight weeks, according to my hand therapist, Logan, my most debilitated finger gained eight degrees of mobility, and its joint lost 12 millimeters of circumference. As a result of reduced swelling, my grip and pinch strength improved more than 10 and 25 percent, respectively.

It's just one move, I tell myself, having returned to Red Cross, three months after starting therapy. I grab the familiar crimp, step my left foot high and weight the injured hand. Something feels different, it's pain free. Instead of dynoing, I lever in and reach high for the nubbin. The move doesn't go, but it feels good. A few tries later, I hit the nubbin accurately, stand on top, and gape at my newfound hands.

Erik Lambert's most recent Rock and Ice contribution was The Power Munch: Eating Right to Stay Light, No. 155. He is currently based in Jackson, Wyoming.

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